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Diffuse pontine gliomas in children: changing strategies, changing results? A mono-institutional 20-year experience

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Abstract

Patients with diffuse pontine gliomas have a median survival of less than one year and represent a challenge for pediatric oncologists, prompting them to attempt experimental therapies. From 1987 to 2005, 62 children with diffuse pontine glioma, not amenable to curative surgery, were treated according to four successive pilot protocols: (1) concomitant chemo–radiotherapy (etoposide, cytarabine, ifosfamide, cisplatin, and dactinomycin); (2) intensive high-dose courses chemotherapy (cisplatin/etoposide, cyclophosphamide/vincristine/methotrexate) and a subsequent course of myeloablative thiotepa followed by radiation and maintenance chemotherapy; (3) cisplatin/etoposide followed by isotretinoin before, during and after focal irradiation; and (4) iv vinorelbine before, during, and after irradiation. Considering all patients, 77% experienced a transient response to treatment, always detectable after radiotherapy. The progression-free survival (PFS) rate was 25 ± 6% at one year, median PFS was seven months; overall survival (OS) was 45 ± 6%, median OS was eleven months: no statistical differences in the four studies in terms of outcome were detected. Despite improved diagnostic, therapeutic, and supportive tools in pediatric neuro-oncology, little has been achieved for patients with diffuse pontine tumors.

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Acknowledgements

The authors are indebted to the Associazione “Bianca Garavaglia”, Busto Arsizio, Milano, for partial financial support (scholarships).

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Authors and Affiliations

  1. Pediatric Oncology Unit, Fondazione IRRCCS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Maura Massimino, Filippo Spreafico, Veronica Biassoni, Fabio Simonetti, Michela Casanova, Andrea Ferrari, Cristina Meazza, Roberto Luksch, Monica Terenziani, Graziella Cefalo, Marta Podda, Daniela Polastri, Carlo A. Clerici & Franca Fossati-Bellani

  2. Developmental Neurology Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria, 20133, Milan, Italy

    Daria Riva

  3. Radiology Unit, Fondazione IRRCCS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Giovanna Trecate

  4. 1st Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria, 20133, Milan, Italy

    Sergio Giombini

  5. Acquired Cerebral-lesions Unit, Fondazione IRCCS Eugenio Medea, Bosisio Parini, LC, Italy

    Geraldina Poggi

  6. Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Emilia Pecori

  7. Physics Unit, Fondazione CS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Emanuele Pignoli

  8. Radiotherapy Unit, Fondazione IRRCCS Istituto Nazionale Tumori, Via Venezian 1, 20133, Milan, Italy

    Lorenza Gandola

Authors
  1. Maura Massimino
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  2. Filippo Spreafico
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  3. Veronica Biassoni
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  4. Fabio Simonetti
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  8. Geraldina Poggi
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  9. Emilia Pecori
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  11. Michela Casanova
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  12. Andrea Ferrari
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  13. Cristina Meazza
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  14. Roberto Luksch
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  15. Monica Terenziani
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  16. Graziella Cefalo
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  17. Marta Podda
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  18. Daniela Polastri
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  19. Carlo A. Clerici
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  20. Franca Fossati-Bellani
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  21. Lorenza Gandola
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Corresponding author

Correspondence to Maura Massimino.

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Massimino, M., Spreafico, F., Biassoni, V. et al. Diffuse pontine gliomas in children: changing strategies, changing results? A mono-institutional 20-year experience. J Neurooncol 87, 355–361 (2008). https://doi.org/10.1007/s11060-008-9525-5

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  • DOI: https://doi.org/10.1007/s11060-008-9525-5

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